ETHICS prpjet Flashcards
APA’s (2016) Ethical Principles of Psychologists and Code of Conduct (“Ethics Code”) consists of four sections:
APA’s (2016) Ethical Principles of Psychologists and Code of Conduct (“Ethics Code”) consists of four sections:
(a) The Introduction and Applicability section states that the Ethics Code “applies only to psychologists’ activities that are part of their scientific, educational, or professional roles as psychologists.” However, it also states that the APA Ethics Committee may take action against members of APA not only in response to complaints of unethical conduct but also after a member’s “conviction of a felony, expulsion or suspension from an affiliated state psychological association, or suspension or loss of licensure.” As noted by Fisher (2017), the felony conviction does not have to be related to activities the member performed in his or her role as a psychologist.
(b) The Preamble states that the primary goals of the Ethics Code are to ensure “the welfare and protection of the individuals and groups with whom psychologists work and the education of members, students, and the public regarding ethical standards of the discipline.”
(c) There are five General Principles: Beneficence and Nonmaleficence, Fidelity and Responsibility, Integrity, Justice, and Respect for People’s Rights and Dignity. The General Principles provide aspirational guidelines that are intended to “inspire psychologists toward the very highest ethical ideals of the profession.” For example, Principle B (Fidelity and Responsibility) states that “psychologists strive to contribute a portion of their professional time for little or no compensation or personal advantage.” This means that providing pro bono services (work provided without charge) is recommended by the Code but is not required.
(d) The Ethical Standards are “enforceable rules of conduct” that are mandatory and can be enforced by the APA Ethics Committee and other state or professional organizations that adopt the Ethics Code. The Ethical Standards are divided into ten categories: Resolving Ethical Issues, Competence, Human Relations, Privacy and Confidentiality, Advertising and Other Public Statements, Record Keeping and Fees, Education and Training, Research and Publication, Assessment, and Therapy.
Resolving Ethical Issues:
Resolving Ethical Issues: Standard 1 (Resolving Ethical Issues) of the Ethics Code addresses conflicts between ethical and legal or organizational requirements, ethical violations by colleagues, responding to requests from ethics committees, and avoiding unfair discrimination against complainants and respondents in an ethics complaint.
- Resolving Ethical and Legal/Organizational Conflicts: Conflicts between ethical requirements and laws, regulations, and organizational demands are addressed in the Introduction and Standards 1.02 and 1.03 of the APA Ethics Code. For example, Standard 1.02 states that, when conflicts occur, “psychologists clarify the nature of the conflict, make known their commitment to the Ethics Code, and take reasonable steps to resolve the conflict consistent with the General Principles and Ethical Standards of the Ethics Code.” It also states that, “under no circumstances may this standard be used to justify or defend violating human rights.” This provision requires psychologists to make a reasonable effort to resolve a conflict in a way that’s consistent with ethical responsibilities but does not require them to abide by ethical responsibilities in all situations. As noted by Fisher, “when reasonable actions taken by psychologists do not resolve the conflict, they are permitted to make a conscientious decision to comply with the legal or regulatory authority under circumstances in which their actions cannot be used to justify or defend violating human rights” (2017, p. 59).
- Ethical Violations by Colleagues: Responding to ethical violations by colleagues is addressed in Standards 1.04 and 1.05: Standard 1.04 requires psychologists to attempt to resolve another psychologist’s ethical violation informally by bringing the violation to the psychologist’s attention when it seems appropriate to do so. Standard 1.05 requires psychologists to report an ethical violation to an ethics committee, licensing board, or other appropriate authority or to take other “action appropriate to the situation” when the ethical violation has caused or is likely to cause substantial harm, is not appropriate for informal resolution, or was not adequately resolved informally. It’s important to note that Standards 1.04 and 1.05 apply only when intervening does not violate any confidentiality rights. For example, if a current client tells you she was sexually harassed by her previous therapist but doesn’t want you to tell anyone, you would maintain confidentiality and not take any action against the therapist.
Koocher and Keith-Spiegel (2008) have identified several situations that may not be amenable to informal resolution. For example, informal resolution may not be appropriate or possible when the psychologist’s violation involves addiction to alcohol or drugs or is related to a serious emotional disturbance or mental illness, when the violation is due to the psychologist’s general incompetence, or when pre-existing bad feelings between the psychologists would make an informal approach too confrontational.
- Requests from Ethics Committees: Standard 1.06 requires psychologists to cooperate with investigations and proceedings of the APA and affiliated psychological associations to which they belong, and it states that failing to do so constitutes an ethical violation. However, like Standards 1.04 and 1.05, Standard 1.06 requires psychologists to consider issues related to confidentiality. For instance, if you’re asked by an ethics committee to provide it with information about a current client who has filed a complaint against her previous therapist, you’d want to make sure the client has signed an authorization for release of information before doing so.
- Unfair Discrimination: Standard 1.08 states that psychologists must not discriminate against others when making decisions about their employment, advancement, tenure, or admissions to academic programs solely because they’ve filed or are the subjects of an ethics complaint. However, it also states that this prohibition “does not preclude taking action based upon the outcome of such proceedings or considering other appropriate information.”
Competence
Competence: Standard 2 (Competence) of APA’s Ethics Code addresses working within the boundaries of one’s competence, delegating work to others, and dealing with personal problems.
- Boundaries of Competence: Standard 2.01 requires psychologists to “provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.” Standard 2.01 also addresses competence in specific situations: For example, Standard 2.01(b) applies to situations in which scientific or professional knowledge has established that an understanding of issues related to gender, gender identity, race, ethnicity, or other characteristic is essential for ensuring that professional services are effective. It states that, to provide services to individuals with these characteristics, psychologists must have the necessary knowledge and training; and, if they do not, they should make appropriate referrals.
Standards 2.01(c), 2.01(d), and 2.02 apply when psychologists want or are asked to provide services that are outside their current boundaries of competence: Standard 2.01(c) states that, when psychologists want to provide services to new populations or use new techniques, they “undertake relevant education, training, supervised experience, consultation, or study.” This situation is addressed by Koocher and Keith-Spiegel (2008), who note that determining whether it’s better to refer or treat a client whose needs are outside a psychologist’s level of competence depends on the circumstances: When there’s a substantial difference between the client’s needs and the psychologist’s competence and an alternative provider is available, referral is ordinarily the best choice. But, in other circumstances, seeing the client while obtaining consultation and/or additional training and education may be an acceptable course of action.
Standard 2.01(d) applies when psychologists are asked to provide services when they do not have adequate competence and alternative services are not available. It states that psychologists may provide the services when they have closely related training and experience and make a “reasonable effort” to obtain appropriate knowledge, training, and/or consultation. Standard 2.02 allows psychologists to provide professional services in emergency situations, even if they do not have adequate training, when alternative services are unavailable and they discontinue the services as soon as the emergency has ended or appropriate services become available.
Standard 2.01(e) addresses the use of new techniques for which there is no consensus about what constitutes competence. It states that, “in those emerging areas in which generally recognized standards for preparatory training do not yet exist, psychologists nevertheless take reasonable steps to ensure the competence of their work and to protect clients/patients, students, supervisees, research participants, organizational clients, and others from harm.” Telepsychology is an emerging area, and competence in the delivery of telepsychology services is addressed in Guideline 1 of the APA’s Guidelines for the Practice of Telepsychology. It states that “psychologists who provide telepsychology services strive to take reasonable steps to ensure their competence with both the technologies used and the potential impact of the technologies on clients/patients, supervisees, or other professionals” (2013, p. 793). This includes obtaining the education and training needed to develop and maintain adequate competence in the delivery of telepsychology services and being familiar with research evaluating the effectiveness of telepsychology for different disorders and for clients with different cultural, socioeconomic, and other characteristics. Because of the relative newness of telepsychology, training standards are still being developed and will continue to evolve as technology changes. Consequently, whenever psychologists are uncertain about their competence to provide telepsychology services, the best course of action is to consult with a colleague who has expertise in providing those services. With regard to research, Guideline 1 notes that a lack of empirical evidence for providing therapy via telephone or other telecommunication format “in and of itself, may not be grounds to deny providing the service to a client/patient” (p. 794). However, in this situation, the client should be informed about the lack of empirical evidence and his/her treatment options.
Finally, Standard 2.04 requires psychologists to base their work on “established scientific and professional knowledge of the discipline.” This includes using evidence-based methods of assessment and treatment when they’re available and applicable to a particular client and situation. As defined by the APA Presidential Task Force on Evidence-Based Practice, “evidence-based practice in psychology (EBPP) is the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences” (2006, p. 273).
- Delegating Work to Others: Standard 2.05 states that a psychologist must delegate responsibilities to employees, supervisees, research assistants, interpreters, and others only when (a) the person the work is being delegated to does not have a multiple relationship with the recipient of the services that could impede his or her objectivity and effectiveness; (b) the person has adequate competence to provide the services independently or while being supervised as determined by his/her education, training, and experience; and (c) the psychologist ensures that the person provides the services competently. For example, it would be unethical for a therapist to recruit a therapy client’s family member to act as an interpreter when the client does not speak the same language as the therapist because the family member’s relationship with the client is likely to affect his/her objectivity.
With regard to the use of an interpreter, Novotney (2020) notes that not all jurisdictions require interpreters to be licensed or certified, and she recommends that, whenever possible, psychologists use the services of professional interpreters who are certified by a national organization (e.g., the National Board of Certification for Medical Interpreters) and adhere to the National Code of Ethics and Standards of Practice of the National Council on Interpreting in Health Care. She also states that it’s important to obtain a client’s consent before bringing in an interpreter to assist with therapy or assessment and to discuss with the interpreter the need to maintain client confidentiality. Tribe and Thompson (2017) recommend that psychologists have written guidelines and a contract for interpreters that address confidentiality and other relevant issues, and Novotney states that psychologists who are subject to HIPAA must have a business associate agreement with the interpreter that specifies the interpreter’s responsibilities with regard to confidentiality.
When delegating work to an employee or supervisee, psychologists must be aware that, in certain circumstances, they may be subject to vicarious liability – i.e., they may be legally responsible for the actions of the employee or supervisee. For vicarious liability to occur, (a) the psychologist must have the authority to control the employee or supervisee, (b) the employee’s or supervisee’s conduct must have deviated from the standard of care and must be the cause of the damage to the recipient of the services, and (c) the employee’s or supervisee’s conduct must have been within the scope of his or her designated responsibilities (Meyer, Simon, & Shuman, 2010).
- Personal Problems: Standard 2.06 requires psychologists to (a) refrain from beginning a professional activity when it’s likely that a personal problem will impede the psychologist’s effectiveness and (b) “take appropriate measures” when they become aware that a personal problem might negatively affect an ongoing professional activity. It also states that an appropriate measure might be to seek consultation to determine whether an ongoing professional activity should be limited, suspended, or terminated.
